Provider Demographics
NPI:1619635406
Name:MYERS, GRETA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2307
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:110 SCOTTSVILLE CTR STE B
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24590-7001
Practice Address - Country:US
Practice Address - Phone:540-437-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16210225100000X
PAPT028056225100000X
NH5649225100000X
VA2305216969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist